Thursday, June 25, 2015

The 80-Hour Resident Work Rule

The 80-Hour Resident Work Rule

In the past, there was conflict with the number of hours medical residents were allowed to work in one week. If you have ever heard of Libby Zion, then you know exactly why that is. She was a patient who died at the age of 18 of serotonin syndrome under the care of what her father considered ‘overworked residents’ and ‘intern physicians’. Because of this, ACGME (the Accreditation Council for Graduate Medical Education) adopted a regulation similar to the Libby Zion Law, also known as the NY State Department of Health Code, Section 405. The regulation put a clinical-hour (‘duty’) maximum on all ‘residents’ of accredited medical training institutions. These ‘duty hours’ are limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities and all moonlighting’ as stated in the ACGME Common Duty Hour Requirements document. The document also states that PGY-1 (postgraduate year-1) residents are currently limited to duty periods of 16-hours duration, while PGY-2 residents are limited to a maximum of 24 hours of continuous duty in the hospital.

In physician assistant education, program ‘work hours’ during clinical rotations are often ‘set by the preceptor’ and can include night, weekends, holidays, and on-call shifts. Students are usually required to work a minimum of 30 hours per week (on average, 40 hours); however, rotation sites may require students to work substantially more per week. The current maximums are set by each program, but tend not to exceed 80 hours per week. As stated, each program has set its own maximums ranging from 50-80 hours per week, which is why students should ask about rotation-hour maximums or requirements before applying. Again, this number may vary depending on the type of rotation and the preceptor. For example, in surgery or emergency medicine rotations, students may determine they wish to spend additional hours on the rotation. During this time, the preceptor must be available for supervision, consultation, and teaching, or designate an alternate preceptor. Students are also often required to make up clinical hours lost due to religious or personal holidays, if allowed. This is a crucial concept for applicants of PA programs to consider when looking for the perfect program ‘fit’. If you have a family or other obligations that may deter you from working an 80-hour requirement, you may consider applying elsewhere. It is my hope that this article has increased your own awareness of the 80-hour Resident Work Rule; if you have any other questions, please leave them below.